Therefore, the coexistence of the two mutations greatly exacerbates tumorigenesis, metastasis, and lymph node metastasis in PTC, and it has been demonstrated that the two-gene mutations have the following prognostic or therapeutic aggressiveness ranking for PTC patients: BRAF + TERT+ > BRAF - TERT+ > BRAF + TERT- (60). Here, TERT is linked to metastatic malignant neoplasm in the lymph nodes.